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Development of a Survey of Teamwork and Task Load Among Medical Providers: A Measure of Provider Perceptions of Teamwork When Caring for Critical Pediatric Patients

Zajano, Emily A. MD*; Brown, Linda L. MD, MSCE; Steele, Dale W. MD; Baird, Janette PhD; Overly, Frank L. MD; Duffy, Susan J. MD, MPH

doi: 10.1097/PEC.0000000000000085
Original Articles

Introduction Teamwork training focuses on improving patient outcomes through better communication. Scales exist to assess providers’ perceptions of teamwork; however, they are not designed for use immediately after the care of critically ill patients.

Objectives This study aimed to develop a survey to quantify providers’ perceptions of teamwork and task load during critical care resuscitations in a PED and to use the tool to compare physician and nonphysician ratings of resuscitations.

Methods Survey items were adapted from validated tools. The resulting survey contained 15 Likert scale items completed by providers immediately after resuscitations. An exploratory factor analysis was conducted. Mixed models, accounting for clustering of providers within resuscitations, tested for systematic differences in responses between physicians and nonphysicians and explored how well the factor scores predicted the overall “smoothness” of the resuscitation.

Results Six hundred fifty-four surveys from 169 resuscitations were conducted. The exploratory factor analysis identified 2 factors with 13 items explaining 47% of the overall variance of “teamwork and communication” (Cronbach α = 0.80) and “task load” (Cronbach α = 0.77). There were no differences in factors predicting smoothness between physicians and nonphysicians (P = 0.27). Both were significant positive predictors of the outcome “the resuscitation went smoothly.”

Conclusions The Survey of Teamwork and Task Load among Medical Providers was developed to evaluate providers’ perceptions of teamwork immediately after care of critically ill patients in a pediatric emergency department. Items reflect 2 constructs, with good internal consistency. Responses did not vary by professional training, suggesting that it is useful for all providers. Both factors predicted the overall smoothness. Each was useful in predicting the perception that the resuscitation went smoothly.

From the *Pediatric Emergency Medicine, Section of Emergency Medicine, New Hampshire’s Hospital for Children and Elliot Hospital, Manchester, NH; and †Department of Emergency Medicine, Section of Pediatrics, and ‡Division of Injury Prevention, Department of Emergency Medicine, Hasbro Children’s Hospital, Alpert Medical School of Brown University, Providence, RI.

Disclosure: The authors declare no conflict of interest.

Reprints: Emily A. Zajano, MD, 1 Elliot Way, Elliot Hospital, Emergency Medicine Specialists, Manchester, NH 03103 (e-mail:

The funding for this project was provided through a grant from Rhode Island Hospital’s Risk Management Foundation.

© 2014 Lippincott Williams & Wilkins, Inc.